Dental Benefits (Relevant Professional Bodies under subsection 32B(4)) Declaration 2017

Overview

The Dental Benefits Act 2008 was enacted to facilitate the payment of dental benefits through the Child Dental Benefits Schedule. This Act establishes a compliance regime to ensure that dental benefits are paid appropriately and addresses the need for the Chief Executive Medicare to obtain relevant documents for compliance purposes. However, the Act explicitly prohibits the CEM from requiring the production of documents from the patient or the person who incurred the expense of the dental service. Instead, the Act requires consultation with a relevant professional body to ascertain the types of documents needed for a compliance audit. The Dental Benefits (Relevant Professional Bodies under subsection 32B(4)) Declaration 2017, issued by the Minister for Health and the Minister for Sport, declares the Australian Dental Association as a relevant professional body under section 32B(4) of the Act. This declaration ensures that the CEM must consult with the ADA before exercising powers under Part 4A of the Act. The ADA, as the peak representative body for dentists in Australia, was deemed appropriate for this role without further consultation. The Declaration is compatible with human rights as it does not engage any applicable rights or freedoms and is purely of a machinery nature.

Scope and Application

The Dental Benefits (Relevant Professional Bodies under subsection 32B(4)) Declaration 2017 applies to the Dental Benefits Act 2008 by designating the Australian Dental Association as a relevant professional body under section 32B of the Act. This declaration is specifically aimed at enhancing the compliance regime established in Part 4A of the Act, which governs the Child Dental Benefits Schedule. By consulting with the ADA, the Chief Executive Medicare is enabled to better ascertain the types of documents required for compliance audits related to dental benefits, while ensuring that patients' privacy is respected by not requiring documents directly from them. The declaration operates nationally, reflecting the Act's Commonwealth jurisdiction. The ADA, as the peak representative body for dentists in Australia, was deemed appropriate for this role without the need for additional consultation. The Declaration is a legislative instrument that commenced on the day after its registration on the Federal Register of Legislation and aligns with the human rights recognised in the Human Rights (Parliamentary Scrutiny) Act 2011.

Key Provisions

The Dental Benefits (Relevant Professional Bodies under subsection 32B(4)) Declaration 2017 (the Declaration) is a legislative instrument that designates the Australian Dental Association (ADA) as a relevant professional body under the Dental Benefits Act 2008 (the Act). This designation is pursuant to subsection 32B(4) of the Act, which empowers the Minister to declare bodies as relevant professional entities for the purposes of section 32B (subsection 32B(4)). The Act facilitates the payment of dental benefits through the Child Dental Benefits Schedule, and Part 4A of the Act establishes a compliance regime for this schedule. Under this regime, the Chief Executive Medicare (CEM) can obtain documents pertinent to audits, but cannot require production of documents from patients or beneficiaries. Before requiring the production of documents, section 32B of the Act requires the CEM to consult with a relevant professional body about the types of documents that contain information relevant to a compliance audit of a dental benefit paid in respect of a dental service. The ADA, being the peak representative body for dentists in Australia, is deemed the most appropriate organisation to act as a relevant professional body under the Act, thereby exempting the need for further consultation. The Declaration mandates that the CEM must consult the ADA about the types of documents that contain information relevant to substantiate a dental benefit paid in respect of a dental service under the Child Dental Benefits Schedule before exercising their powers under Part 4A. The Declaration is compatible with the human rights and freedoms recognised or declared in the international instruments listed in section 3 of the Human Rights (Parliamentary Scrutiny) Act 2011. It does not engage any of the applicable rights or freedoms as it is machinery in nature. Consequently, this Declaration is compatible with human rights as it does not raise any human rights issues. The obligations imposed by the Declaration on the parties it governs are primarily procedural. The CEM is required to consult with the ADA before obtaining documents pertinent to compliance audits under Part 4A of the Act. This obligation ensures that the CEM receives expert advice on the types of documents that contain information relevant to a compliance audit of a dental benefit paid in respect of a dental service. Failure to comply with this requirement may result in the CEM exercising their powers under Part 4A without sufficient information, potentially leading to erroneous decisions regarding the payment of dental benefits. There are no specific offences, penalties, or civil/criminal consequences outlined in the Declaration for breach of its provisions. However, non-compliance with the consultation requirement may have administrative consequences. If the CEM fails to consult with the ADA, they may exercise their powers under Part 4A without the benefit of expert advice, potentially leading to erroneous decisions regarding the payment of dental benefits. Such errors could result in overpayments or underpayments of dental benefits, which could lead to financial losses for the government or patients. Additionally, failure to consult with the ADA could result in legal challenges to the CEM's decisions, which could further exacerbate these consequences.